HH Demo for Mailed Requests (Michigan and Massachusetts)

Pre-Claim Review Demonstration For Home Health Services (CMS-10599)

OMB: 0938-1311

IC ID: 222825

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

HH Demo for Mailed Requests (Michigan and Massachusetts)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction PCRD_HH_Operational_Guide.pdf Yes No Printable Only

Health Health Care Services

 

795 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 21,828 21,828 0 0 0 0
Annual IC Time Burden (Hours) 10,914 10,914 0 0 0 0
Annual IC Cost Burden (Dollars) 109,140 109,140 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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